Sat.Nov 16, 2024 - Fri.Nov 22, 2024

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What Does it Mean to Own the Next 4 Years?

Science Based Medicine

It means pertussis and measles outbreaks will be happening under your watch and you'll be held responsible while your boss is an anti-vaxx crank. Enjoy! The post What Does it Mean to Own the Next 4 Years? first appeared on Science-Based Medicine.

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

Authors: Bricey Bayonnet, MD ( EM Resident Physician, Atrium Health’s Carolinas Medical Center, Charlotte, NC); Christine Murphy, MD (EM Attending Physician; Medical Toxicologist, Atrium Health’s Carolinas Medical Center, Charlotte, NC) // Reviewed by: James Dazhe Cao, MD (@JamesCaoMD, Associate Professor of EM, Medical Toxicology, UT Southwestern Medical Center, Dallas, TX); Anthony Spadaro MD, (@TSpadaro91, Fellow in Medical Toxicology, Rutgers NJMS); Alex Koyfman, MD (@EMHighAK); Brit Long, M

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Critical Care Evidence Updates – October 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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JC: Small versus Large-Bore Thoracostomy for Traumatic Hemothorax.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and fewer tube days. This review explores outcomes in drainage efficacy, complication rates, and patient comfort, showing that small-bore thoracostomy may be a reliable alternative for non-emergent cases.

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Laptop Class Doctors Think Doctors Who Treat Patients Are Lazy, Dumb, Cowardly, Sheep

Science Based Medicine

Had laptop class doctors been willing to listen to doctors who worked on COVID units, they wouldn't have said so many absurd things. The post Laptop Class Doctors Think Doctors Who Treat Patients Are Lazy, Dumb, Cowardly, Sheep first appeared on Science-Based Medicine.

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SGEM#460: Why Do I Feel Like, Somebody’s Watching Me – CHARTWatch to Predict Clinical Deterioration

The Skeptics' Guide to EM

Date: October 28, 2024 Reference: Verma et al. Clinical evaluation of a machine learning–based early warning system for patient deterioration. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto. He leads an AI team intending to improve patient outcomes and healthcare system efficiency.

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EMCrit 388 – Experts’ Guide to the Bougie with Barnicle and Driver

EMCrit

Experts' guide to the use of the Bougie for Emergency Airway Management EMCrit Project by Scott Weingart, MD FCCM.

More Trending

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A New DC Degree. What the World Needs Now.

Science Based Medicine

Perhaps the neck manipulation was a bit too aggressive. The post A New DC Degree. What the World Needs Now. first appeared on Science-Based Medicine.

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Levitan/Rezaie Practical Airway Course

RebelEM

View Course Dates This 2-day course provides an in-depth look at effective surgical airway management techniques that you will actually use in your next emergency airway. There is a unique focus on airway anatomy and imaging combined with one-of-a-kind opportunity to practice the techniques on a large variety of non-embalmed, specially prepared cadavers.

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First10EM Journal Club: November 2024

Broome Docs

Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST. Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Resuscitation. 2024 Aug;201:110266. doi: 10.1016/j.resuscitation.2024.110266. Epub 2024 Jun 9. PMID: 38857847 Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest.

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Small Bore vs Large Bore Thoracostomy for Traumatic Haemothorax.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients. Dive in to explore the latest evidence in trauma management and see if small-bore thoracostomy is suitable for your practice’s patient population. The post Small Bore vs Large Bore Thoracostomy for Traumatic Haemothorax. appeared first on St.Emlyn's.

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FDA poised to reshape the cold remedy aisle

Science Based Medicine

The FDA is proposing to order the removal of phenylephrine from oral cough and cold remedies. The post FDA poised to reshape the cold remedy aisle first appeared on Science-Based Medicine.

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Emergency Evidence Updates – October 2024

The Bottom Line

What’s new in the Critical Care literature – monthly updates

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Journal update: monthly top five

Emergency Medicine Journal

This month’s update is by the Emergency Medicine team in South East Scotland. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper.

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Intra-Arrest Arterial Blood Pressure and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed This retrospective study explores the link between intra-arrest arterial blood pressure (IBP) and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). The post Intra-Arrest Arterial Blood Pressure and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest. appeared first on St.Emlyn's.

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Unleashing innovative marketing insights to connect the dots for patient experience initiatives

NRC Health

Consumers expect always-on connectivity, transparency, and personalization; so, to drive loyalty, the Wexner Medical Center has focused on delivering individualized, high-quality patient experiences while enhancing its digital front door. The post Unleashing innovative marketing insights to connect the dots for patient experience initiatives appeared first on NRC Health.

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Protected: Are AEDs Eligible for FSA/HSA Funds?

AED Leader

This content is password protected. To view it please enter your password below: Password: The post Protected: Are AEDs Eligible for FSA/HSA Funds? appeared first on AEDs for Sale | Buy Defibrillators and Accessories.

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Cross-cultural limitations in the discussion of evidence-based versus person-centred approaches to care for older, frail patients

Emergency Medicine Journal

I read with interest the frailty practice review by Van Oppen et al in which they suggest that existing emergency department (ED) guidelines and protocols poorly represent older people living with frailty. They recommend that clinicians caring for these patients should not only appraise the available evidence in the context of an individual’s situation and values but also consider the person’s personal preferences to truly deliver person-centred care. 1 They highlight the fact that e

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Imaging Case of the Week 610

EMergucate

The chest x-ray is from an adult with chest pain post MVA. What can be seen?

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A fabulous virtual education session on delivering and receiving feedback from the AAP Section on Emergency Medicine

PEMBlog

I am excited to share the recording of the AAP Section on Emergency Medicine Fall Virtual Education Session , originally held on Tuesday, November 19, 2024 focused on delivering timely and actionable feedback, along with strategies to develop and implement sustainable feedback programs. PEM educators shared their experiences and provided practical strategies to strengthen evaluation processes and initiatives in this multidisciplinary, interactive session.

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Air pollution: a silent enemy for our health

Emergency Live

Prolonged exposure to fine dust significantly increases the risk of developing type 2 diabetes A recent study has revealed a worrying link between air pollution and type 2 diabetes. Researchers have found that prolonged exposure to fine dust, those tiny invisible particles that pollute the air we breathe, Significantly increases the risk of developing this […] The post Air pollution: a silent enemy for our health appeared first on Emergency Live.

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Abstracts from international emergency medicine journals

Emergency Medicine Journal

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.

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ECG of the Week 20 Nov 24

EMergucate

A 60yr old female presents to ED with 3hrs of pleuritic chest pain radiating to the back associated with diaphoresis.

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Best Side To Infraclavicular | Pediatric Opioid Guidelines

JournalFeed

The JournalFeed podcast for the week of Nov 11-15, 2024. These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Tuesday Spoon Feed: In this randomized control trial of left versus right ultrasound-guided infraclavicular subclavian central venous access, the left-sided approach was associated with a lower catheter malposition rate.

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Stable Vaginal Bleeding in Pregnancy

EM Ottawa

A common Emergency Department (ED) presentation, vaginal bleeding in pregnancy affects approximately 30% of pregnancies in the 1st trimester and 1-2% in the 2nd trimester. About half of these result in pregnancy loss. Here we will use cases to highlight an ED approach to stable vaginal bleeding in pregnancy with an emphasis on: Management of […] The post Stable Vaginal Bleeding in Pregnancy appeared first on EMOttawa Blog.

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Man with a royal headache and neck pain

Emergency Medicine Journal

Clinical introduction A 71-year-old man presented to the ED with progressive headache and neck pain. The patient had no visual, neurological, chest or abdominal symptoms. Temperature was 38.8°C, he was fully conscious with no signs of meningeal irritation. C reactive protein was 85 mg/L. CXR and brain CT were unremarkable; cerebrospinal fluid analysis was normal.

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EM@3AM: Total Hip Arthroplasty Complications

EMDocs

Authors: Steven Wright, MD (EM Resident Physician, UTSW – Dallas, TX); Samia Farooqi, MD (Assistant Professor of EM/Attending Physician, UTSW – Dallas, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

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Electrophysiology is on the brink of a possible disaster

Stop and Think

The OPTION trial compared two strategies to reduce stroke and bleeding after catheter ablation of atrial fibrillation. The current strategy is to continue an anticoagulant medication. The alternative tested in OPTION is to implant a left atrial appendage device—abbreviated as LAAC (left atrial appendage closure). AF ablation is one of the most common procedures in my field.

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Instructor Collection ECG: Anterior M.I. and Left Ventricular Hypertrophy

ECG Guru

The Patient: Sixty-year-old man with a complaint of severe substernal chest pain. Denies hx of M.I., but reports feeling short of breath on exertion for about a year. Hx of hypertension, but admits he is non-compliant with his medication. Appears pale and diaphoretic, BP 110/68. The ECG: The rhythm is sinus at 62 bpm. The QRS is slightly wide at 110 ms (.11 seconds), but still within normal limits.

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JC: The Association Between Intra-Arrest Arterial Blood Pressure and Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest.

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed This retrospective study explores the link between intra-arrest arterial blood pressure (IBP) and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). Analysing data from 80 patients attended by the East Anglian Air Ambulance, it found that higher diastolic blood pressure (DBP) during CPR significantly increased the likelihood of ROSC.

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A woman in her 40s with acute chest pain and shortness of breath

Dr. Smith's ECG Blog

Written by Pendell Meyers A woman in her 40s presented with acute chest pain and shortness of breath. Vitals were within normal limits. Here is her triage ECG: What do you think? Smith : This is classic for pulmonary embolism (PE). There are 2 key points to making this diagnosis on the ECG: 1) There is T-wave inversion which you might think is due to Wellens' waves, but the patient has active symptoms, so it is not Wellens' sydrome 2) The T-wave inversion in V1-V4 is accompanied by T-wave invers

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How to Build Trust in End-of-Life Care Discussions 

American Medical Compliance

According to a review by the Center for Bioethics and Health Law , patients who received early palliative care not only experienced significant improvements in their quality of life and mood but also lived 25% longer. This underscores the profound impact that compassionate and proactive care can have. End-of-life care discussions rank among the most sensitive and challenging conversations healthcare providers engage in with patients and their families.

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ChatGPT triumphs over academic physicians in diagnostic reasoning challenge

PulmCCM

ChatGPT crushed 50 academic attendings and residents in a diagnostic reasoning contest. At the end of 2023, 26 attendings and 24 residents (mostly in internal medicine at Stanford, Beth Israel/Harvard, and the University of Virginia) read clinical case vignettes and were randomized to answer them either with conventional resources like decision support tools (e.g., Google search, UpToDate™), or to use ChatGPT-4.

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Medical Malpractice Insights: Neurologist discharged with spinal epidural abscess

EMDocs

Here’s another case from Medical Malpractice Insights – Learning from Lawsuits , a monthly email newsletter for ED physicians. The goal of MMI-LFL is to improve patient safety, educate physicians and reduce the cost and stress of medical malpractice lawsuits. To opt in to the free subscriber list, click here. Stories of med mal lawsuits can save lives.

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Is this OMI reperfused or active?

Dr. Smith's ECG Blog

These ECGs were texted to me by one of our previous ultrasound fellows, Will Smoot An elderly male arrived via EMS for acute substernal chest pain with radiation to left shoulder and arm that awakened him from sleep at 0030. He took two full strength aspirin prior to EMS arrival. The pain was relieved by one prehospital NTG spray. He arrived at the ED just shy of two hours after onset, pain free.

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Subgroups, Specialties, and Prior Hypotheses

Sensible Medicine

Posting this article was a no brainer. It is a critical appraisal deep dive by “friend of the stack” David Rind that combines the “letter to the editor” feel that we like so much as well some nice EBM history. Enjoy. Adam Cifu Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.

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Your Brain In Space

Science Based Medicine

Amid all the shocking and depressing news regarding the future of American healthcare and medicine, at least over the next four years, I thought I would tackle something a bit lighter today. What happens to the brains of astronauts aboard the ISS? Space medicine is a field of study, if fairly niche, and will likely have increasing implications as humanity increases its […] The post Your Brain In Space first appeared on Science-Based Medicine.

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